Yukna R A, Callan D P, Krauser J T, Evans G H, Aichelmann-Reidy M E, Moore K, Cruz R, Scott J B
Department of Periodontics, Louisiana State University School of Dentistry, New Orleans 70119-2799, USA.
J Periodontol. 1998 Jun;69(6):655-63. doi: 10.1902/jop.1998.69.6.655.
A synthetic cell-binding peptide (P-15) combined with anorganic bovine-derived hydroxyapatite bone matrix (ABM) was compared to demineralized freeze-dried bone allograft (DFDBA) and open flap debridement (DEBR) in human periodontal osseous defects in a controlled, monitored, multi-center trial. Following appropriate initial preparation procedures, flap surgery with defect and root debridement was performed. Three osseous defects per patient were treated randomly with one of three procedures after surgical preparation. Appropriate periodontal maintenance schedules were followed, and at 6 to 7 months re-entry flap surgery was performed for documentation and finalization of treatment. Analysis of variation (ANOVA) and t test analyses of patient mean values from 31 patients revealed that the combination ABM/P-15 grafts demonstrated significantly better mean defect fill of 2.8 +/- 1.2 mm (72.3%) versus a mean defect fill of 2.0 +/- 1.4 mm (51.4%) for defects treated with DFDBA (P <0.05) and a mean defect fill of 1.5 +/- 1.3 mm (40.3%) (P <0.05) for defects treated with DEBR. Other hard tissue findings showed similar clinically superior results with the use of ABM/P-15. Relative defect fill results showed 87% positive (50% to 100% defect fill) responses with ABM/P-15, 58% positive responses with DFDBA, and 41% positive responses with DEBR. There were 8 to 9 times more failures (minimal response) with DFDBA and DEBR (26% to 29% frequency) than with ABM/P-15. Soft tissue findings showed no significant differences among treatments except for greater clinical attachment level gain with ABM/P-15 compared to DEBR. These results suggest that the use of the P-15 synthetic cell-binding peptide combined with ABM yields better clinical results than either DFDBA or DEBR. Further studies are needed to determine the relative roles of the ABM and/or the P-15 in these improved results.
在一项对照、监测的多中心试验中，将一种合成细胞结合肽（P-15）与无机牛源羟基磷灰石骨基质（ABM）的组合，与脱矿冻干骨同种异体移植物（DFDBA）和开放瓣清创术（DEBR）在人类牙周骨缺损治疗中进行了比较。经过适当的初始准备程序后，进行了带有缺损和牙根清创的瓣手术。每位患者的三个骨缺损在手术准备后随机采用三种程序之一进行治疗。遵循适当的牙周维护计划，在6至7个月时进行再次入路瓣手术，以记录和完成治疗。对31名患者的平均值进行方差分析（ANOVA）和t检验分析发现，ABM/P-15移植物组合的平均缺损填充效果显著更好，为2.8±1.2毫米（72.3%），而DFDBA治疗的缺损平均填充为2.0±1.4毫米（51.4%）（P<0.05），DEBR治疗的缺损平均填充为1.5±1.3毫米（40.3%）（P<0.05）。其他硬组织结果显示，使用ABM/P-15也有类似的临床优势。相对缺损填充结果显示，ABM/P-15的阳性（50%至100%缺损填充）反应率为87%，DFDBA为58%，DEBR为41%。DFDBA和DEBR的失败（最小反应）次数比ABM/P-15多8至9倍（频率为26%至29%）。软组织结果显示，除了与DEBR相比，ABM/P-15的临床附着水平增加更大外，各治疗组之间无显著差异。这些结果表明，P-15合成细胞结合肽与ABM联合使用产生的临床效果优于DFDBA或DEBR。需要进一步研究以确定ABM和/或P-15在这些改善结果中的相对作用。
